摘要
目的 探讨单纯前路手术治疗成人下颈椎结核的手术有效性和术后中期疗效。方法 采用前路彻底病灶清除、髂骨支撑植骨、钢板螺钉内固定术治疗并获得完整随访资料的成人下颈椎结核40例,其中男23例,女17例;年龄16-68岁,平均（43.23±12.27）岁。术后给予超短程化疗,对手术时间、术中出血量、术后并发症、ESR与CRP变化、病灶治愈及植骨融合、Frankel分级、后凸角纠正等方面进行综合评价。结果 平均随访时间（52.18±29.20）个月、手术时间（122.24±25.18）min、术中出血量（150.30±35.42）m L。39例于病灶清除彻底术后6个月治愈;1例因术中病灶残留,于术后2年治愈;1例术后出现取髂骨处切口感染,前路支撑植骨平均（4.84±1.21）个月达到了骨性融合。6例合并神经功能障碍患者,术后6个月时均达到Franke E级。后凸畸形矫正率为（80±8）%,末次随访后凸角丢失为（3.50±1.50）°。结论 单纯前路手术治疗成人下颈椎结核疗效优良,具有利于病灶清除、减压,椎间髂骨植骨支撑效果好、融合率高、前路钢板螺钉固定可靠、远期后凸角无明显丢失的特点。
Objective To investigate the effect of the anterior surgery treatment for lower cervical tuberculosis and mid - term after the operation in adults. Method 40 adults suffered from lower cervical tuberculosis were involved in our study,including 23 males and 17 females. All cases had an average of （43.23 ＋ 12.27） years （range, 16 -68years ）. All cases received anterior radical debride- ment, interbody iliac strut bone graft, the fixation of internal planting. And all cases were given the ultra - short - course chemotherapy af- ter operation. The changes of operation time,total blood loss,postoperative complications, ESR and CRP of all cases were observed. Com- prehensive evaluation of fusion status and the recovery of nidus, Frankel grade, the corrections of kyphosis angle were also performed in the study. Result The average duration of the follow - up was （ 52.18 ~ 29.20） months. The operation time was （ 122.24 ~ 25.18 ） minutes and the total blood loss was （ 150.30 ~ 35.42） milliliters. 39 cases received radical debridement were cured in 6 months after operation. One case was cured in two years later after operation due to residual nidus in the operation and the other one was infected post- operative surgical incision in iliac bone. Anterior interbody iliac strut bone graft achieved bony fusion for （4.48 ~ 1.21 ） months. 6 cases with neurological deficit recovered to Frankel grade E in 6 months after operation. The average correction rate was （ 80 ＋ 8 ） % with the loss of correction of（3.50 ~ 1.50） ~. Conclusion The anterior surgery treatment is reliable for lower cervical tuberculosis in adults, which benifits debridement, decompression and iliac interbody at diseased level, and high rate of bone graft fusion. The fixation of anterior cervical planting is firm with no obvious loss of kyphosis angle in the long - term.
出处
《宁夏医学杂志》
CAS
2016年第12期1170-1173,共4页
Ningxia Medical Journal
基金
宁夏科技惠民计划科研课题(20139477)
关键词
颈椎结核
成人
前路手术
超短程化疗
Lower cervical tuberculosis
Adult
Anterior surgery treatment
Ultra - short - course chemotherapy
